Marijuana has long been considered the gateway drug to other, more dangerous substances. Common lore would have everyone believing that after a few hits, teens find themselves spiraling down a rabbit hole, experimenting with more menacing drugs, such as cocaine.

The focus needs to shift.

No one is saying marijuana can’t lead to bigger problems, or isn’t a problem in and of itself. But prescription drugs by far now account for teens turning to more hardcore highs — including the deadly drug heroin.

Seventy-five percent of high school students who have done heroin report abusing opioids first, according to a recent study. The research, “Nonmedical Opioid Use and Heroin Use in a Nationally Representative Sample of U.S. High School Seniors,” was published in the Drug and Alcohol Dependence journal in November.

Joseph J. Palamar works with an affiliate of the Center for Drug Use and HIV Research. He is also an assistant professor of population health at New York University Langone Medical Center in Manhattan. He led the study, the first in the nation to examine the link between nonmedical use of opioids and heroin in high school students.

"This link is obvious, but unfortunately it has largely been unstudied," Palamar told LifeZette. "Today, most people who initiate heroin are those who have become hooked on opioid pills such as Vicodin or Oxycontin. Our findings confirm that more frequent use of these pills increases the risk of moving onto heroin."

Where are they getting it? Wake up, Mom and Dad.

"A few close friends used painkillers for fun. They took Vicodin and Oxycontin," a 21-year-old male from New York City told LifeZette. "They either stole them from their parents or were actually injured at some point and just enjoyed them, so they stuck with it."

The 21-year-old, who asked to remain anonymous, attended high school in Bergen County, New Jersey, one of the hardest hit in the nation when it comes to heroin use, abuse and deaths.

More than 5,000 deaths in Bergen County have been reported due to heroin since 2004, says State officials have declared the problem an "epidemic" and say the resurgence of the drug in recent years has been linked to the widespread availability and abuse of prescription painkillers.

"It starts at a party with a painkiller and ends alone at night in your bedroom," said Sgt. David Borzotta of the Bergen County Prosecutor’s Office Narcotics Task Force.

A growing number of legislators, members of law enforcement and school officials throughout the country are trying to raise awareness about the problem, and to let parents know what they should look for in their children.

Symptoms of drug use include mood changes, which can be seen as normal teenage behavior. But track marks on the skin, changes in relationships anger, and dramatic weight loss or gain should be further investigated.

"This horrible situation is mainly a result of poor drug education in the U.S.," Palamar said.

He added that preventing teens from ever starting on pills will decrease heroin initiation. Once they've started however, cutting off their pill supply increases the chance a user will turn to the deadly drug.

"Teens addicted to pills often move onto heroin because they either can no longer afford their expensive pill habit, or their pill source has been cut off. Limiting access to pills ... encourages users to move onto heroin, which is cheaper and more available than pills," said Palamar.

Dr. Maria Aszalos, Dr. Joseph Lee and Dr. David Kan, all addiction specialists, added that tackling the availability of drugs needs to be addressed. Accessibility is a major hurdle in battling this drug epidemic.

"Doctor shopping" and a lack of communication between providers remains a huge part of the problem, according to Kan, an addiction specialist who used to run an opioid treatment program. He said people are still easily able to go from doctor to doctor and complain about pain, then receive prescription medication without doctors knowing what has already been prescribed.

Solutions won't, or can't, come about overnight. But while an increasing number of families mourn the loss of loved ones due to drug overdoses, and more teens turn to opioids and other narcotics each day, doctors say the best defense parents can have is to educate themselves about the dangers and keep a close eye on their children. If they notice any potential problems, they should intervene as early as possible.

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